OBJECTIVE To assess the correlation between the steady-state minimal concentration （cmin） and 24 h area under the drug concentration-time curve （AUC24）/minimal inhibitory concentration （MIC） ratio （AUC24/MIC） of vancomycin in pediatric patients， and analyze independent risk factors for treatment failure. METHODS Data of hospitalized children treated with vancomycin and receiving therapeutic drug monitoring in our hospital from January 2021 to July 2024 were retrospectively collected and divided into success group and failure group according to whether the treatment was successful or not. Spearman correlation analysis was used to analyze the correlation between cmin and AUC24/MIC of vancomycin， and one-way and multifactorial Logistic regression analyses were used to screen the independent risk factors for vancomycin treatment failure. RESULTS A total of 59 children were included， with 41 in the success group and 18 in the failure group. Compared with the failure group， AUC24/MIC of vancomycin was significantly higher in the success group （P＝0.038）， but there was no statistically significant difference in the cmin of the two groups （P＞0.05）； cmin of vancomycin was significantly positively correlated with AUC24/MIC （r＝0.499， P＜0.001）， but it has a certain efficacy in predicting the achievement of the AUC24/MIC standard （≥400） （area under the receiver operator characteristic curve＝0.696）， with an optimal cutoff value of 6.05 mg/L determined by the Youden index. The efficacy of AUC24/ MIC in predicting treatment failure was superior to cmin （areas under the receiver operator characteristic curve were 0.671 vs. 0.523， P were 0.038 vs. 0.684）， with higher sensitivity （83.3% vs. 66.7%）. Hypoproteinemia and AUC24/MIC≤369.1 were independent risk factors for vancomycin treatment failure （P＜0.05）. The incidence of nephrotoxicity was 3.4%. CONCLUSIONS There is a significant positive correlation between cmin and AUC24/MIC of vancomycin in pediatric patients； hypoproteinemia and AUC24/MIC≤369.1 are independent risk factors for vancomycin treatment failure in children.

Objective To observe the clinical and symptomatic improvement three months after uterine artery embolization(UAE),and to analyze the value of apparent diffusion coefficient(ADC)in MR diffusion weighted imaging(DWI)in assessing the response of fibroids volume after UAE.Methods A total of 40 patients with uterine fibroids were included.The volume changes of fibroids,clinical and symptomatic improvement before and after treatment were recorded,and the efficacy of UAE was comprehensively analyzed.All patients underwent MR DWI before UAE and were evaluated at three months postoperatively by outpatient MR follow-up,with fibroids vol-ume and ADC quantitative measurements were performed to compare the changes in ADC values of fibroids preoperatively and post-operatively at each b value.Pearson correlation analysis was performed to analyze the correlation between baseline ADC values and postoperative fibroids volume reduction.Regression analysis was performed to assess the relationship between ADC and fibroids volume reduction after UAE.And the receiver operating characteristic(ROC)curve were plotted to analyze the predictive value of ADC values for evaluating fibroids volume reduction of more than 30％after UAE.Results The patients'clinical symptoms was improved in the three months after surgery,the volume of fibroids was significantly reduced,and the life quality was improved,the difference was sta-tistically significant(P＜0.05).There was no significant effect on ovarian function,hormone levels did not change significantly com-pared to before surgery,with no statistical significance(P＞0.05).When b=50,1 000 s/mm2,the changes in ADC values before and after uterine fibroids treatment were not significant,with no statistical significance(P＞0.05).However,the changes in ADC values before and after uterine fibroids treatment were significant when b=800 s/mm2 and the difference was statistically significant(P＜0.05).Under the condition of b=800 s/mm2,Pearson correlation analysis showed ADC value had a positive correlation with postoperative uterine fibroids volume reduction rate(r=0.45,P＜0.05),and the area under the curve(AUC)for ADC value to predict the reduction rate of uterine fibroids volume by more than 30％after UAE was 0.787.The cut-off value was 1.143 × 10-3 mm2/s,with sensitivity and specificity of 0.793 and 0.818,respectively.Conclusion UAE is more effective in treating uterine fibroids.The baseline ADC value of uterine fibroids correlated significantly with the volume reduction after UAE.The ADC value can be used to assess the volume response after UAE.

Phytoremediation plays an important role in the treatment of heavy metal pollution in soil. In order to elucidate the mechanism of salicylic acid (SA) on copper absorption, seedlings from Xuzhou (with strong Cu-tolerance) and Weifang Helianthus tuberosus cultivars (with weak Cu-tolerance) were selected for pot culture experiments. 1 mmol/L SA was sprayed upon 300 mg/kg soil copper stress, and the photosynthesis, leaf antioxidant system, several essential mineral nutrients and the changes of root upon copper stress were analyzed to explore the mechanism of copper resistance. The results showed that Pn, Tr, Gs and Ci upon copper stress decreased significantly compared to the control group. Meanwhile, chlorophyll a, chlorophyll b and carotenoid decreased with significant increase in initial fluorescence (F₀), maximum photochemical quantum yield of PSⅡ (Fv/Fm), electron transfer rate (ETR) and photochemical quenching coefficient (qP) content all decreased. The ascorbic acid (AsA) content was decreased, the glutathione (GSH) value was increased, the superoxide dismutase (SOD), catalase (CAT) and ascorbate peroxidase (APX) activity in the leaves were decreased, and the peroxidase (POD) activity was significantly increased. SA increased the Cu content in the ground and root system, and weakened the nutrient uptake capacity of K, Ca, Mg, and Zn in the root stem and leaves. Spray of exogenous SA can maintain the opening of leaf stomata, improve the adverse effect of copper on photosynthetic pigment and PSⅡ reaction center. Mediating the SOD and APX activity started the AsA-GSH cycle process, effectively regulated the antioxidant enzyme system in chrysanthemum taro, significantly reduced the copper content of all parts of the plant, and improved the ion exchange capacity in the body. External SA increased the content of the negative electric group on the root by changing the proportion of components in the root, promoted the absorption of mineral nutrient elements and the accumulation of osmoregulatory substances, strengthened the fixation effect of the root on metal copper, and avoided its massive accumulation in the H. tuberosus body, so as to alleviate the inhibitory effect of copper on plant growth. The study revealed the physiological regulation of SA upon copper stress, and provided a theoretical basis for planting H. tuberosus to repair soil copper pollution.
Antioxidants ; Copper ; Helianthus/metabolism* ; Salicylic Acid/pharmacology* ; Chlorophyll A/pharmacology* ; Spectroscopy, Fourier Transform Infrared ; Chlorophyll/pharmacology* ; Ascorbic Acid ; Superoxide Dismutase/metabolism* ; Photosynthesis ; Glutathione ; Plant Leaves ; Stress, Physiological ; Seedlings

Objective:To screen high-risk population of chronic obstructive pulmonary disease (COPD) and to analyze the risk factors in Haicang District of Xiamen City.Methods:A questionnaire survey was conducted from February 2023 to May 2023 among residents who visited or underwent physical examinations at five community health service centers in Haicang District of Xiamen City selected by cluster sampling method. The self-designed general information questionnaire, COPD population screening questionnaire (COPD-PS) and COPD screening questionnaires (COPD-SQ) were applied in the survey. Individuals with COPD-PS scale>5 or COPD-SQ scale>16 were defined as COPD high-risk group. The association of COPD risk with gender, age, smoking, family history of COPD, history of tuberculosis, history of COVID-19 infection, and using coal/woodstove for cooking or heating was analyzed with chi-square test and binary logistic regression analysis.Results:A total of 4 260 questionnaires were distributed and 4 221 valid questionnaires were collected with a recovery rate of 99.6%. Among all respondents there were 1 904 males (45.11%) and 2 317 females (54.89%); and 217 individuals aged 40-<50 (5.14%), 434 aged 50-<60 (10.28%), 2 194 aged 60-<70 (51.98%), 1 302 aged 70-<80 (30.85%) and 74 aged≥80 (1.76%). The results showed that there were 269 respondents (6.4%) scored≥5 on the COPD-PS scale, 534 residents (12.7%) scored≥16 on the COPD-SQ scale, 646 (15.3%) scored≥5 on the COPD-PS scale or≥16 on the COPD-SQ scale. Male gender ( OR=2.592, 95% CI:2.135-3.146), second-hand smoke exposure ( OR=3.763, 95% CI:2.944-4.810), frequently catching cold before the age of 14 ( OR=3.804, 95% CI:2.927-4.944), history of tuberculosis ( OR=2.575, 95% CI:1.224-5.418), hypertension ( OR=1.547, 95% CI:1.277-1.875), and diabetes ( OR=1.791, 95% CI:1.027-3.121) were independently associated with the high-risk of COPD, while the history of COVID-19 ( OR=0.583, 95% CI:0.476-0.714) was a protective factor for COPD risk. Conclusion:Males, exposure to second-hand smoke, frequently catching cold before the age of 14, history of tuberculosis, hypertension, and diabetes will increase the risk of COPD, while the history of COVID-19 is a protective factor.

Objective:To investigate the effect of an improved hydro-colloid dressing sticking method on preventing protective equipment induced facial pressure injuries among medical staff through a prospective, single-arm trial.Methods:According to the size of the edge of N95 mask, four pieces of hydro-colloid dressing with a size of 2 cm×5 cm were cut, and the edges of the mask were tension-free stuck. This improved sticking method was applied to the nurses working in the isolation ward. The follow-up was continued for two weeks, skin condition was reported daily, and the occurrence of pressure ulcers was analyzed after two weeks of follow-up.Results:Twenty percent (4/20) of subjects experienced increase grades of nasal and twenty five percent (5/20) in cheek pressure ulcers during a two-week follow-up. The incidence of the increased stage of cheek pressure ulcer in normal/dry skin was higher than in oily skin. Stage 2 pressure ulcers occurred in only five percent (1/20) of subjects, and no subjects had stage 3 or higher stage pressure ulcers. The incidence of increased cheek pressure ulcer grade in patients with neutral / dry skin was (5/11), higher than 0 in patients with oily skin ( χ2 value was 5.378, P = 0.02). The stage of nasal pressure ulcer was positively correlated with the disappearance time of the indentation of protective equipment ( r value was 0.615, P=0.004). The rate of increase in nasal pressure sore grade was higher in subjects who required more than 120 minutes of indentation recovery time (2/8) than in subjects who required 30 to 60 minutes 1/5 ( χ2 value was 4.382, P<0.05) and 60-120 minutes 1/5 ( χ2 value was 6.472, P<0.05). Conclusions:This improved hydro-colloid dressing sticking method can effectively prevent pressure injuries related to wearing N95 masks for a long time. However, skin evaluation of medical staff should be done properly, moisture protection for normal/dry skin should be emphasized, and skin blood flow recovery after compression should be strengthened. This method can reduce the risk of infection of medical staff, and it is worthy of clinical application.

Objective To investigate the dynamic changes of neutrophil gelatinase-associated lipoca-lin(NGAL) and kidney injury molecule 1(KIM-1) in children after contrast media administration and evalu-ate the effect of hydration therapy. Methods A total of 58 patients with urinary system diseases who were admitted to Shengjing Hospital of China Medical University from March 2012 to March 2014 for intravenous pyelography(IVP) in pediatric department were enrolled. The 58 patients were randomly divided into hydra-tion group of 28 patients and non-hydration group of 30 patients. Contemporaneous 24 patients received respiratory system enhanced CT examination without urinary tract diseases and hydration were enrolled as control group. Urine NGAL and KIM-1 of the three groups at 0 h,24 h,48 h,72 h,96 h after using intravenous contrast media were detected by ELISA. Serum creatinine of the three groups at 0 h,48 h,96 h after using intravenous contrast media were detected. Results All of the 82 subjects in this study didn′t occur contrast- induced acute kidney injury. The urinary NGAL of non-hydrated group significantly increased at 24 h and 48 h after contrast media administration ( P < 0. 05 ) and the urinary NGAL of hydrated group significantly increased at 48 h and 72 h(P<0. 05). But the urinary NGAL at 24 h and 48 h of the hydration group were lower than these of the non-hydrated group,there were statistically significant differences(P<0. 05). At 24 h,48 h and 72 h after contrast media administration,the level of urine KIM-1 in the non-hydration group sig-nificantly increased(P<0. 05). Urine KIM-1 at 48 h and 72 h in the hydration group significantly increased (P<0. 05). But the urine KIM-1 at 24 h,48 h and 72 h of the hydration group were lower than these of the non-hydration group,the differences were statistically significant(P<0. 05). Comparison of urine NGAL and KIM-1 at different times before and after contrast media administration in children receiving enhanced CT examination who without urinary tract disease showed no statistically significant differences ( P >0. 05 ). Conclusion The urine NGAL and KIM-1 of children with urinary system diseases increase after contrast media administration and there is a trend of spontaneous recovery. Hydration intervention can alleviate the up-ward trend of urine NGAL and KIM-1. For children receiving enhanced CT examination but without urinary system diseases,the change of urine NGAL and KIM-1 are not significant.

Objective To investigate the prognostic value of microRNA-122 (miR-122) combined with acute physiology and chronic health evaluationⅡ(APACHEⅡ) score in patient with acute respiratory distress syndrome (ARDS), and to provide evidence for the diagnosis and treatment of ARDS. Methods ARDS patients admitted to the Third People's Hospital of Haikou City from January 2016 to December 2018 were enrolled. The general data, serum miR-122 expression level and APACHEⅡ score within 24 hours were collected. The patients were divided into survival group and death group according to the survival status of ARDS patients. ARDS patients were divided into low-risk group ( < 10 scores), medium-risk group (10-20 scores) and high-risk group ( > 20 scores) according to APACHEⅡ score. Predictive values of miR-122 and APACHEⅡ scores on prognosis in ARDS patients were evaluated by the receiver operating characteristic (ROC) curve. The correlation between the serum miR-122 expression and APACHEⅡscore in patients with ARDS was calculated by Pearson correlation analysis. Results A total of 142 ARDS patients were selected, 94 male and 48 female; with age (56.80±11.30) years old; 55 deaths and 87 survivors; 67 of high-risk, 48 of medium-risk and 27 of low-risk. The expression of serum miR-122 and APACHEⅡ score in the death group were significantly higher than those in the survival group [miR-122 (2-ΔΔCt): 0.26±0.12 vs. 0.07±0.03, APACHEⅡ:31.84±4.25 vs. 15.30±2.60, both P < 0.01]. With the severity increase of the disease, the serum miR-122 expression level, APACHEⅡ score, and mortality rate of ARDS patients gradually elevated, and the difference between the two groups was significant in the low-risk group, medium-risk group, and high-risk group [miR-122 (2-ΔΔCt):0.05±0.02, 0.14±0.06, 0.23±0.09; APACHEⅡ: 12.30±2.15, 20.62±3.40, 28.90±3.60; mortality rate: 11.1%, 31.2%, 55.2%, respectively, all P < 0.05]. ROC curve analysis showed that miR-122 and APACHEⅡ score could predict the death of ARDS patients, and the area under the ROC curve (AUC) was 0.835 [95% confidence interval (95%CI) = 0.776-0.893] and 0.790 (95%CI = 0.732-0.854); the predicted value of the miR-122 combined with APACHEⅡscore (AUC = 0.918, 95%CI = 0.857-0.972) was higher than the single miR-122 and APACHEⅡscore (both P < 0.05), with sensitivity and specificity were 91.3% and 86.4% respectively. The correlation analysis showed that the expression of serum miR-122 was positively correlated with APACHEⅡscore in death patient with ARDS (r = 0.825, P < 0.01). Conclusion Elevated serum miR-122 expression level is associated with disease severity and prognosis of ARDS patients; miR-122 combination with APACHEⅡ score has a high evaluation value on prognosis of ARDS patients.

Objective: To develop an HPLC-ELSD method for the simultaneous determination of six saponins constituents including notoginsenoside R1, ginsenoside Rg1, ginsenoside Re, ginsenoside Rb1, ginsenoside Rc and ginsenoside Rd in Xinling pills.Methods: HPLC-ELSD was used, and the chromatographic separation was performed on an Agilent Eclipse XBD-C18 column (150 mm×4.6 mm,5 μm) with acetonitrile-water as the mobile phase with gradient elution at the flow rate of 1.0 ml·min-1, the column temperature was maintained at 20℃, the drift tube temperature was 60℃, and the gas pressure was 4.00 bar.Results: Notoginsenoside R1, ginsenoside Rg1, ginsenoside Re, ginsenoside Rb1, ginsenoside Rc and ginsenoside Rd was linear within the range of 0.30-6.00μg(r=0.999 5), 1.14-22.80μg (r=0.999 6), 0.17-3.40 μg (r=0.999 7), 0.81-16.20 μg (r=0.999 7), 0.08-1.60 μg (r=0.999 8) and 0.07-1.40 μg (r=0.999 8), respectively.The average recovery was 98.23%, 97.98%, 99.14%, 99.15%, 98.72% and 98.37%, and the RSDs were 1.56%, 1.31%, 1.16%, 1.07%, 0.73% and 0.92%(n=6), respectively.Conclusion: The method is convenient, accurate and reproducible in the quality control of saponins components in Xinling pills

Objective To investigate the clinical effect of the acetic acid K point stimulation in thestroke patients with dysphagia in the oral stage.Methods Eighty stroke patients with dysphagia in the oral stage after stroke who were treated in the department of rehabilitation medicine of Lishui People's Hospital from May 2014 to August 2016 were randomly divided into the control group and the experimental group (n=40 in each group). The patients in the control group were given the routine nursing and the basic rehabilitation therapy. The patents in the experimental group were given the acetic acid K point stimulation on the basis of the routine nursing and the basic rehabilitation therapy. The patients in the two groups were evaluated by the X-ray videofluoroscopy swallowing study (VFSS) score and the oral function assessment before the treatment and two weeks after the treatment.Results The VFSS score and the oral function score of the patients in the experimental group were not significantly different from those in the control group before the treatment (control group:t=0.07,experimental group:t=0.03;P>0.05). After the treatment, the VFSS score and the oral function score were (9.40±3.75)and(9.72±4.70)respectively in the experimental group,and (6.20±2.19) and (6.55±3.60)in the control group (t=3.19, 5.79;P<0.01).Conclusions The routine nursing and the rehabilitation therapy combined with the acetic acid K point stimulation can improve the recovery of swallowing function of the stroke patients with dysphagia in the oral stage.

The HPLC fingerprint differences ofRadix Platycodonis from different origins were studied to provide references for their quality control and production. The total platycodins were purified by DB101 macroporous resin. HPLC-ELSD fingerprints of the total platycodins for 39 batches ofRadix Platycodonis samples from 9 provinces were performed on an Agilent HC-C8 column (4.6 mm x 250 mm, 5μm) with gradient elution. The mobile phase was acetonitrile-0.5% acetic acid. The injection volume was 6μL. The flow rate was 0.5 mL·min-1. The temperature of drift tube was set at 90℃. And the gas flow (N2) was set at 1.2 mL·min-1. The results showed that there were large differences in the quality ofRadix Platycodonis from different origins with the common fingerprints of 6 batches of samples fromChifeng in Inner Mongolia as references. The quality ofRadix Platycodonis was closely related to the seeds, the ecological environment, the way of drying and storing and so on. It was concluded that it was important to strengthen the provenance base construction, standardization of the seeds, reasonable formulation of the regionalization, and standardization of the production processing for the cultivation and production ofRadix Platycodonis.